Department of Anaesthesiology, Pharmacology and Intensive Care, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.
Eur J Anaesthesiol. 2010 Aug;27(8):683-9. doi: 10.1097/EJA.0b013e328333de09.
Distractions and interruptions during clinical activities can decrease performance and increase the risk of error. The incidence and impact of distracting events on anaesthetic teams during the critical phases of general anaesthesia are unknown. The purpose of this study was to quantify and analyse the frequency, the source and the impact of these events during the period of induction of general anaesthesia.
Twenty-nine anaesthetic team members participated in the study. Anaesthetic teams were videotaped during the induction period of a general anaesthesia. All videotapes were reviewed by two investigators using a scoring system in order to categorize the distracting events according to their origin, source, nature, duration, impact on patient and consequences on team activities. A total of 37 videotapes of general anaesthesia inductions for urgent surgical cases were analysed.
The results show that the sources of distracting events are multiple and diverse. Distracting events occurred frequently (median five per video) and at least one event was present for 39.5% of the total observed period. They had a significant impact on the activity of the team members during 21.8% of the total observed period and had a negative impact on patient management in one-fifth of the cases.
During the induction phase of general anaesthesia, distracting events are frequent and affect significantly the task at hand. Future research should design and implement preventive strategies to minimize the occurrence of unnecessary distracting events during this critical phase of anaesthesia when calm and vigilance should prevail.
临床活动中的干扰和中断会降低工作效率并增加出错的风险。在全身麻醉的关键阶段，麻醉团队受到干扰事件的发生和影响尚不清楚。本研究的目的是量化和分析在全身麻醉诱导期间这些事件的频率、来源和影响。
29 名麻醉团队成员参与了这项研究。在全身麻醉诱导期间对麻醉团队进行了录像。两名研究人员使用评分系统对所有录像带进行了审查，以便根据干扰事件的来源、来源、性质、持续时间、对患者的影响以及对团队活动的后果对其进行分类。共分析了 37 例紧急手术全身麻醉诱导的录像。
结果表明，干扰事件的来源是多方面的。干扰事件频繁发生（中位数为每个视频 5 次），至少有一次事件发生在总观察期的 39.5%。它们对团队成员的活动有显著影响，占总观察期的 21.8%，并且在五分之一的情况下对患者管理产生负面影响。
在全身麻醉诱导期间，干扰事件频繁发生，严重影响手头的任务。未来的研究应设计和实施预防策略，以尽量减少在麻醉这个关键阶段发生不必要的干扰事件，因为此时应保持冷静和警惕。
